Inertia based microfluidic capture and characterisation of circulating tumour cells for the diagnosis of lung cancer

Identification of circulating tumour cells (CTC) in the blood of patients with cancer is now established in numerous cancers (1-3). The principals of cell capture is either using positive (e.g., cell size, antigen expression) (4-7) or negative (e.g., depletion of normal cells) selection (8) each having benefits and limitations. To date, the use of CTCs in routine clinical management has been limited to the current epithelial cell adhesion molecule (EpCAM)-based immunomagnetic approaches that only detect CTCs that express EpCAM, such as the CellSearch device (3). FDA approval for the CellSearch currently exists only for metastatic breast, prostate and colorectal cancer, thus excluding those CTCs with absent or low EpCAM expression as is the case with lung. Numerous reports have found low CTC recovery in non-epithelial and metastatic cancers such as melanoma, ovarian, pancreatic, and lung (9,10), underscoring the need for improved, unbiased CTC recovery technologies